The Doctor found nothing wrong with my meniscus and my x-ray scans were cleared! What else could it be?
Well, there are alot of other little-known structures around that area such as the Pes Anserinus. The Pes Anserinus literally translates into ‘goose foot’ from Latin. It refers to the three tendons that are attached to that site. Those three tendons belong to the sartorius, gracilis and semitendinosus muscles. The primary role of the Pes Anserinus is to bend your knee and has a role in stabilising your knee to prevent it from collapsing inwards. Underneath these tendons, there lies a bursa (imagine a little ballon or cushion that helps reduce the friction between the tendon and the bone).
The picture below shows the site of pes anserinus in the inner right knee.
What is the cause of my pain then?
Pes anserinus tendinopathy and bursitis are the two most common pes anserinus issues. They are most common in breaststroke swimmers, long distance runners and cyclists. The pes anserinus bursa lies between the bone and the muscle tendons, and can be inflamed as a result of overuse. The tendons can also be compressed or irritated, resulting in tendinopathy.
It can be caused by:
- Activities that require repetitive bending of the knee
- e.g. Long distance running, cycling, squatting, stair climbing
- Sudden increase in activities such as running
- Increase in running incline
- Maladaptive biomechanics during activities
- e.g. Knee collapsing in when running
- Tight or weak hamstrings and quadriceps
- Potentially weak hip muscles
How do I know there might be a problem with my pes anserinus?
The classic presentation of an issue with the pes anserinus is usually pain when walking or running uphills, squatting (because the tendons around the area are being squashed) and maybe some discomfort upon standing after sitting for too long.
So how can Physiotherapy help me?
Our Physiotherapists will assess your knee to ascertain that the issue is from the pes anserinus. We will come up with an individualised management plan suitable for you. We will manage any swelling present with appropriate modalities and techniques and seek to understand the cause of your pain. You will also be advised on activity modification to prevent any further provocation of injury, to facilitate your eventual return to your chosen sport. Afterwhich, some exercises will be prescribed to you for long-term management.
Some exercises you can expect may include:
DISCLAIMER: These exercises should not replace the need for a consultation with a Physiotherapist especially if your condition doesn’t improve with these exercises. Your Physiotherapist will choose exercises that suit your specific needs.
Filed under: Knee